Key result
Compared to factor Xa inhibitors, low-molecular-weight heparin was associated with a significantly higher risk of venous thromboembolism in patients undergoing total knee replacement (OR 2.162).
Why the study?
Does low-molecular-weight heparin reduce venous thromboembolic events compared to other anti-thrombotic agents in patients after total hip or total knee replacement surgery?
Meta-Analysis (n=45,717)
Does low-molecular-weight heparin reduce venous thromboembolic events compared to other anti-thrombotic agents in patients after total hip or total knee replacement surgery?
Odds Ratio: 2.162 (95% CI 1.513–3.089)
p-value: p=<0.001
LMWH may have a higher risk of VTE and DVT compared to factor Xa inhibitors, but a lower risk of major bleeding compared to direct thrombin inhibitors after THR or TKR.
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LMWH inferior to factor Xa inhibitors for VTE prevention after TKR but safer than thrombin inhibitors for bleeding after THR; extends RCT-based comparisons to guide prophylaxis selection.
Lü et al. (2018) conducted a meta-analysis in Venous thromboembolism prevention after total hip or total knee replacement surgery (n=45,717). Low molecular weight heparin (LMWH) vs. Factor Xa inhibitors, direct thrombin inhibitors, or placebo was evaluated on Venous thromboembolism (VTE) in total knee replacement subjects compared to factor Xa inhibitors (OR 2.162, 95% CI 1.513-3.089, p=<0.001). Compared to factor Xa inhibitors, low-molecular-weight heparin was associated with a significantly higher risk of venous thromboembolism in patients undergoing total knee replacement (OR 2.162).
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